UNDINE JULIANE VALLEJOS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050075

License Status

CANCELLED

Business

First Name

UNDINE

Middle

JULIANE

Last Name

VALLEJOS

Suffix

Business Name

UNDINE JULIANE VALLEJOS DO

Original Issue Date

06/20/2005

Effective Date

06/20/2005

Expiration Date

06/30/2008

City

ELMHURST

State

Zip

60126

County

DUPAGE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006